General practitioner Oleg Yuryevich Borisov spoke about the serious consequences of infections that are considered to be children, and what measures to take to avoid them.
There is a group of infectious diseases that the medical community and public consciousness today call “children” by virtue of tradition. They are “Childhood” infections such as measles, diphtheria, chickenpox, rubella, mumps, whooping cough, scarlet fever, poliomyelitis.
Only this group of infections can be called “children’s” diseases that are dangerous for adults. You need to understand that before the mass vaccination against some of them, they managed to get infected with these infections even in childhood. Those who got sick, who became adults, did not become infected with them, since after the transferred infection, immunity to them remained. Due to these historical features, there is no caution in the mass consciousness today about these infections.
They are dangerous due to their high contagiousness (the ability to quickly transmit from a sick person to a healthy person who is susceptible to them) and the appearance of a fairly large layer of adults who, for various reasons, do not have immunity to them today.
These infections are dangerous for adults also because in an adult organism they do not proceed in the same way as in children, but for a longer time, more severe, often with complications.
Most “childhood” infections are mild, that is, they are completely safe. However, there are exceptions. In children, in a certain percentage of cases, they are difficult, with complications up to a lethal outcome – therefore, mass vaccination against most of them was introduced.
In a society where vaccination coverage against “childhood” infections reaches 95% or more, adults are not in danger. This was the case before: in Russia, some “childhood” infections have become controllable, that is, no cases of the disease have been recorded for several years.
– This disease is very dangerous for both children and adults. Today, measles is recorded mainly among the adult population, its share in the total number of cases is 78,4%. More than half of adults 18–35 years old were not vaccinated or were vaccinated once.
– Most deaths from measles are due to complications associated with the disease. Most often, complications develop in children under the age of five or in adults over 20 years of age. The most serious complications include blindness, encephalitis (an infection that causes swelling of the brain), severe diarrhea and associated dehydration, ear infections, and severe respiratory tract infections (such as pneumonia).
– Adults suffer from measles longer and more severely (cough, runny nose, throat hyperemia, conjunctivitis, sore throat, high temperature for 5-7 days, intense headache). The measles virus is associated with the development of chronic diseases such as systemic lupus erythematosus, Paget’s disease, multiple sclerosis, glomerulonephritis.
– Infected women are also at risk of developing serious complications during pregnancy, and pregnancy may end in miscarriage or premature birth.
– Prevention of measles: routine – two doses of the vaccine (at the age of 12 months and 6 years). The effectiveness of vaccinations is 95–98%. Post-vaccination immunity lasts at least 25 years. According to epidemiological indications, the following population groups are vaccinated: contact persons from the foci of the disease, who have not been ill, have not been vaccinated and have no information about preventive vaccinations against measles, who have been vaccinated once without age limitation.
– Measles treatment: There is no specific medicine to fight the measles virus. Treatment is aimed at eliminating symptoms and preventing the development of a bacterial infection.
Rubella is usually a mild viral infection that most commonly affects children and young people. The greatest harm is caused by rubella, affecting the fetus when a pregnant woman is ill.
Features of the course of the disease in adults:
– During periods of an epidemic rise in the incidence of rubella among children, the number of cases among adults is growing. By the way, adults sometimes get sick with rubella even though they had it in childhood.
– In adults, a more severe course than in children: prolonged and high fever, late onset of the rash, profuse small-spotted rash, prolonged period of exanthema.
– The most dangerous complications: encephalitis, meningoencephalitis, encephalomyelitis. Other complications: pneumonia, otitis media, tonsillitis, arthritis associated with the addition of a secondary infection. The development of hemorrhagic syndrome is possible: hemorrhages in the skin, mucous membranes, bleeding of various localizations, increased fragility of blood vessels.
– The greatest danger of rubella is due to the tropism to embryonic tissue. It is estimated that more than 100 babies with congenital rubella syndrome are born worldwide each year. The degree of fetal damage depends on the gestational age. Rubella disease of a pregnant woman at 000-3 weeks of pregnancy causes congenital malformations in 4%, and at 60-13 weeks – in 16%. When a pregnant woman gets sick, the virus enters the placenta and infects the fetus.
– In addition to the teratogenic (causing fetal deformities) effect of the virus on the fetus, other types of pregnancy complications may occur: miscarriage (10–40%); stillbirth (20%); early neonatal mortality (25%); general underdevelopment, sepsis.
– Rubella is associated with the development of type 1 diabetes.
– Prevention of rubella: first vaccination: 12–15 months. Revaccination: 6 years. Vaccination of girls aged 13 years who have not previously been vaccinated or have received only one vaccination. Girls from 18 to 25 years old, not sick, not previously vaccinated.
– Treatment is aimed at eliminating symptoms, preventing and treating complications. Antiviral agents have not been developed at this time.
– Most often adolescents get sick with mumps, much less often adults. In addition, vaccinations against this disease are not always a guarantee that a person will not be able to get it. Most often, outbreaks of infection are observed in closed groups.
Complications of the disease include:
– Mumps orchitis (inflammation of the testicles). Occurs in 30-40% of adult men, leads to infertility.
– Serous meningitis (inflammation of the meninges) occurs in 5–20% of adults.
– Possible complications of mumps: inflammation of the heart muscle, mammary glands in 30% of women, thyroid gland, nerves, joints, blood disease. Associated with the development of type 1 diabetes mellitus.
– Prevention of mumps: routine vaccinations twice at 12 months and 6 years for children who do not have mumps. According to epidemic indications: contact persons from the foci of the disease, who were not sick, not vaccinated and who do not have information about preventive vaccinations against mumps.
– Treatment is aimed at preventing complications. There is no antiviral treatment for mumps.
– The maximum morbidity in adults is observed after the rise in the incidence in children, which occurs in the winter-spring period. Adults get sick more than children: a prolonged prodromal period with symptoms of intoxication, late appearance of a specific rash, profuse rashes, in most cases – pustular, the presence of bullous, hemorrhagic and gangrenous forms.
– The crusting period comes later and lasts longer. There is a high and prolonged fever.
– In adults, the following complications are more often observed: pneumonia in 15%, inflammation of the brain, complications of a purulent nature. In persons over 15 years of age, complications and the need for hospitalization are observed more often.
– After the transferred chickenpox, the virus remains in the human body for life. With a decrease in immunity, it manifests itself in the form of shingles.
– Prevention of chickenpox: vaccination of children over one year old, it is not included in the national immunization schedule and is done at the discretion of the parents. With timely initiation of treatment and application of antiviral therapy no later than from the 2nd day of the disease, the course of the disease is significantly facilitated.
– Every 10 years it is necessary to repeat the vaccination against this disease, since the immunity from it is not lifelong.
– There is a serious problem – low and untimely vaccination coverage. This leads to the emergence of a layer of adults who currently do not have protection against diphtheria. In adults, there is an increased susceptibility to diphtheria. In unvaccinated people, the disease is severe, there is a risk of death.
– Sometimes diphtheria is diagnosed late due to the fact that it proceeds like a sore throat, which people often try to treat themselves. In addition, there are atypical localization of diphtheria.
– Prevention of diphtheria: routine immunization – primary immunization (3-4,5-6 months) revaccination (18 months), revaccination (6-7 years), revaccination (14 years), revaccination (adults over 18 years old – every 10 years) … According to epidemic indications, contact persons are vaccinated from the foci of the disease who have not been ill, have not been vaccinated and have no information about preventive vaccinations against diphtheria.
– Treatment of diphtheria: a specific treatment for the patient is antitoxic antidiphtheria serum (PDS). The earlier the treatment is started, the better the result. Antimicrobial drugs must be used in patients with toxic forms of diphtheria, diphtheria croup, mixed infection.
– According to the World Health Organization, about 60 million people fall ill with whooping cough in the world every year, about 1 million children die, mainly under the age of one year. In children, the disease often becomes severe, and in adults it may remain undiagnosed. Thus, adults with undiagnosed whooping cough are the main source of infection for children. In adults, the cough accompanying this disease persists for a long time, even with normal health.
– Today, parents are more likely to refuse to vaccinate their children, while they themselves, as a rule, are already vaccinated. It is in such families that a situation can arise when parents can become a source of infection for their child with all possible consequences.
– Complications of whooping cough: pneumonia, conjunctivitis, nosebleeds, hernias, atelectasis, lesions from the central nervous system (from mild convulsions to coma – irreversible brain damage).
– Prevention of pertussis: the first vaccination for healthy children is carried out at 3 months, then the vaccine is administered at 4, 5, 6 and 18 months.
– Treatment of whooping cough: specific anti-pertussis gammaglobulin is used. Also antibiotics for severe and complicated forms.
– Children under 5 and unvaccinated adolescents are more likely to suffer from poliomyelitis. Adults also become infected, but less often. Due to the fact that in Russia polio vaccination is carried out from childhood, cases of the disease, as a rule, proceed under the guise of ARVI. It does not come to paralysis.
– The disease progresses more severely if an adult with a weakened immune system or HIV infection is infected. Paralysis and death occurs if vaccination has not been carried out.
– Prevention against poliomyelitis: the first injection of inactivated vaccine (IPV) is carried out at 3 months; at 4,5 months – the second IPV is introduced; at 6 months – the third IPV; at 18 months, a second revaccination with the introduction of an oral vaccine (OPV) is carried out; at 20 months – the second revaccination with OPV; at the age of 14, the last polio vaccine is given.
– Persons who have come into contact with those arriving from polio-endemic (unfavorable) countries are vaccinated from 3 months of age without age restrictions.
– Polio treatment: There is no specific antiviral treatment.
– In adults infected with scarlet fever, the disease proceeds in an erased form, possibly a severe course with the development of a toxic-septic form. With improper treatment, self-medication and even self-healing, allergic complications to the valvular apparatus of the heart, kidneys, joints, and the central nervous system are possible in the future.
– Scarlet fever spreads as follows: a sick adult becomes a source of infection for his children.
– Prevention of scarlet fever: this disease does not require vaccination.
– Timely treatment with antibiotics allows you to quickly recover and avoid complications.
General recommendations on how to protect yourself from a “child” infection:
– consult a doctor on the first day of illness, do not wait “until it passes by itself”, and do not self-medicate;
– know about the ways of transmission of infectious diseases, observe hygiene, vaccinate before traveling to endemic regions;
– lead a healthy lifestyle, keep yourself in good shape, do not allow prolonged psycho-emotional overstrain, feelings of anxiety and fear. Feel happy, eat right and get enough rest – this will ensure good immunity;
– know that there are modern vaccines against measles, rubella, mumps, diphtheria, pertussis, poliomyelitis, which need to be vaccinated;
– observe the timing of immunization in accordance with ;
– be aware that there are vaccines against infections that are not yet included in the Calendar of Preventive Vaccinations, and they can also be vaccinated (chickenpox, etc.).